Provider Demographics
NPI:1922066471
Name:SMITH, MICHAEL JOSEPH JR (PT/AT/DPT)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:SMITH
Suffix:JR
Gender:M
Credentials:PT/AT/DPT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:7516 COUNTRY PRIDE LN
Mailing Address - Street 2:
Mailing Address - City:IMLAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48444-9530
Mailing Address - Country:US
Mailing Address - Phone:989-390-1825
Mailing Address - Fax:
Practice Address - Street 1:7516 COUNTRY PRIDE LN
Practice Address - Street 2:
Practice Address - City:IMLAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48444-9530
Practice Address - Country:US
Practice Address - Phone:989-390-1825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2025-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI55010124092251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic